Mental Health and Substance Abuse Programs in alphabetical

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DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 172 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1546 M & S CLINICAL SERVICES, INC. MARK FOSSIE 2821 N 4TH STREET, #516 MILWAUKEE, WI 53212 County: Milwaukee msclinical516@sbcglobal.net Phone: (414) 263-6000 Fax: (414) 263-2270 Surveyor: Demetrius Anderson Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 12/04/1996 03/01/2011 02/28/2013 Mental Health Outpatient Clinic DHS 35 CSAS-Day Treatment DHS 75.12 CSAS-Outpatient Treatment DHS 75.13 1547 M. BURTON PSYCHOLOGICAL SERVICES MARIANNE BURTON 11035 W. FOREST HOME AVENUE HALES CORNERS, WI 53130 County: Milwaukee drmburton@gmail.com Phone: (414) 425-2258 Fax: No Number Provided Surveyor: Demetrius Anderson Services STATE OF WISCONSIN Bureau of Health Services PO Box 2969 Madison, WI 53701-2969 Tier/ Branch Begin/ Branch Location(s) End Dates NO BRANCH LOCATIONS Administrative Code Chapter Service Begin/End Dates 11/01/1994 11/01/2007 10/31/2009 Mental Health-Outpatient DHS 61.91 1549 MADISON HEALTH SERVICES CHAD REDMAN 3113 E. WASHINGTON AVENUE MADISON, WI 53704 County: Dane credman@crchealth.com Phone: (608) 242-0220 Fax: (608) 242-1166 Surveyor: William Rohner Services NO BRANCH LOCATIONS 03/01/2011 02/28/2013 06/13/2012 02/28/2013 03/01/2011 02/28/2013 Administrative Code Chapter Service Begin/End Dates 01/01/1994 07/01/2012 06/30/2014 CSAS-Narcotic Treatment DHS 75.15 CSAS-Outpatient Treatment DHS 75.13 NO BRANCH LOCATIONS 11/01/2007 10/31/2009 Administrative Code Chapter Service Begin/End Dates 07/01/2012 06/30/2014 07/01/2012 06/30/2014
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 173 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1550 MADISON MENTAL HEALTH SERVICES JAMES MCGLOIN 702 N BLACKHAWK AVENUE, #104 MADISON, WI 53705 County: Dane jmcgloin@wisc.edu Phone: (608) 231-2008 Fax: (608) 231-2312 Surveyor: William Rohner Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 04/01/1981 04/01/2009 06/30/2009 Mental Health-Outpatient DHS 61.91 1553 MADISON PSYCHOTHERAPY CENTER, LLC MARY ELLEN MILLER 702 N BLACKHAWK AVENUE, #205 MADISON, WI 53705 County: Dane maryellmiller@frontier.com Phone: (608) 233-3037 Fax: (608) 233-5893 Surveyor: William Rohner Services STATE OF WISCONSIN Bureau of Health Services PO Box 2969 Madison, WI 53701-2969 Tier/ Branch Begin/ Branch Location(s) End Dates MADISON MENTAL HEALTH SERVICES Tier 1 715 HILL ST 04/01/2009 MADISON, WI 53705 06/30/2009 Administrative Code Chapter Service Begin/End Dates 11/01/1993 10/01/2010 09/30/2012 Mental Health Outpatient Clinic DHS 35 1554 MAEHNOWESEKIYAH WELLNESS CENTER SHANNON WILBER N2150 KESAEHKAHTEK GRESHAM, WI 54128 County: Shawano No Email Address Provided Phone: (715) 799-3835 Fax: (715) 799-3836 Surveyor: Frank Bellaire Services NO BRANCH LOCATIONS 04/01/2009 06/30/2009 Administrative Code Chapter Service Begin/End Dates 11/21/1989 12/01/2011 11/30/2013 Mental Health Outpatient Clinic DHS 35 CSAS-Day Treatment DHS 75.12 CSAS-Outpatient Treatment DHS 75.13 CSAS-Prevention DHS 75.04 NO BRANCH LOCATIONS 10/01/2010 09/30/2012 Administrative Code Chapter Service Begin/End Dates 12/01/2011 11/30/2013 12/01/2011 11/30/2013 12/01/2011 11/30/2013 12/01/2011 11/30/2013
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